Dr. M.J. Bazos, MD. Patient Handout

About Your Diagnosis
Wolff-Parkinson-White syndrome is commonly referred to as WPW. WPW is a condition in which the ventricles of the heart are electrically stimulated to contract out of sequence with the rest of the heart. The atria of the heart normally receive a signal to
contract and force blood into the ventricle. The ventricle is properly filled before it contracts to send its blood out from the heart. If it is electrically excited out of order, the ventricle contracts before it has been completely filled with blood. This is an arrhythmia called pre-excitation. It can occur on either side of the heart. WPW is the most common type of pre-excitation syndrome. It causes the heart to beat too fast (tachycardia).

Living With Your Diagnosis
This condition is caused by an abnormal electrical pathway leading down to the ventricle from the atria. It can occur because of congenital abnormalities (problems present at birth), heart valve problems, hyperthyroidism, or hypertrophic cardiomyopathy (heart muscle disease). Persons with WPW often have no symptoms except those related to the medical condition that may have caused the WPW. Sometimes symptoms of heart palpitations (irregular, pronounced, rapid beats) cause the heart to beat faster than usual for no apparent reason. You may have fainting or spells of lightheadedness. About half of persons with WPW never have symptoms. WPW is not rare, but because many persons with the condition never have symptoms, it is only found when you undergo an electrocardiogram (ECG) for another reason. The diagnosis of WPW is made on the basis of a characteristic pattern on an ECG. Your diet does not generally affect this condition, but a healthy low-fat diet is generally recommended for anyone with a heart condition.

Persons with this condition but no symptoms do not need treatment. They live as long as persons with normal hearts. Persons with symptoms should undergo an ECG while the symptoms are happening so that the physician can check the electrical pattern of the heart. Some patterns may necessitate hospitalization for intravenous medications to control the symptoms. Patients with symptoms not controlled with medications may need to undergo cardioversion (which means shock) or ablation (which means removal) of the electrical pathways. Patients with symptoms of WPW frequently are able to stop the tachycardia by using one of several maneuvers. Straining (as if lifting something heavy) may slow the rapid heart rate. Gently massaging the carotid artery in the neck for a few seconds or applying a cold, wet towel to the face for a few minutes may slow the heart rate. These techniques should be tried as soon as symptoms are felt for best results. Persons with frequent, recurrent symptoms may need medications. Medications for WPW are used either to manage the condition causing the arrhythmia or to control the response of the ventricle to the abnormal electrical pathway. Medications used to treat recurrent symptoms of WPW include atenolol, amiodarone, quinidine, procainamide, or propranolol. The side effects of the medications should be monitored. Each of these medications can cause nausea, vomiting, or diarrhea. Each may lower the blood pressure
and may cause additional arrhythmias. Atenolol and propranolol are beta-blockers and should be used with caution by persons with diabetes or asthma. They may decrease the ability to exercise because they prevent the heart from beating too fast. Quinidine may cause fever, rash, or cinchonism (ringing in the ears, dizziness, headache). Procainamide may cause a rash, fever, or joint pain.

The Dos
•Learn the maneuvers used to control tachycardia.
•Take your medications as prescribed.
•Stop smoking.
•Have a stress (exercise) test performed before starting any exercise program.

The DON’Ts
•Do not forget to take your medications on a regular schedule, that is, at the same time each day.
When to Call Your Doctor
•If you have new or worsening symptoms such as uncontrolled rapid heartbeat, fainting, shortness of breath or chest pain.
•If you have side effects of your medications.